The focus of this blog is on the wonders of government-run health-care everywhere but I also note the damage done to private medicine by a legal system that supports predatory litigation.

The long-established socialized medicine systems in Britain and Australia are a particularly relevant warning about where such systems end up.

Posts by John J. Ray (M.A.; Ph.D.)

Saturday, January 02, 2010

British girl, 15, died from series of heart attacks after being sent home from NHS hospital with 'flu'

A girl of 15 died on Christmas Eve from a series of heart attacks just days after begging doctors to keep her in hospital because she felt so ill. Amy Carter lost a stone in weight over a week after initially falling sick with flu-like symptoms at the start of December. However, she was discharged from hospital after tests showed she was suffering from glandular fever.

Richard and Jacqueline Carter said their daughter had asked a doctor at the Worcestershire Royal Hospital in Worcester: 'Am I going to die?' They said the doctor replied: 'Of course not, don't be silly it's a nasty illness but it's certainly not life-threatening.' She was discharged on December 21, two days after she was admitted, and told to take paracetamol and have plenty of rest.

But the next day, Amy was struggling to breathe and was taken to an out-of-hours care centre where a doctor sent her away with instructions to drink lots of fluid.

On the morning of Christmas Eve, her worried parents called their GP, who said Amy's condition was 'critical' and called an ambulance. Despite being given five adrenalin shots into her heart – one for each cardiac arrest – she died just hours later in hospital.

Mrs Carter, 48, from Stourport-on-Severn, Worcestershire said: 'I'm not medically trained but even I could tell she was seriously ill. 'She hadn't eaten for weeks and lost more than a stone. 'We're extremely bitter and feel we have been let down. Her organs basically all failed one by one and her heart was the last to go. 'She was a healthy girl who should never have died.'

Mr Carter, 43, said: 'Amy was very frightened and really did not want to be moved out of hospital. Her condition was deteriorating every day. She knew something was wrong but the doctors refused to listen to her.'

When Amy first fell ill around four weeks ago, her parents, who both run pet shops, took her to the care centre attached to their nearest hospital in Kidderminster. A doctor said she had sinusitis – an inflammatory condition of the sinuses – and sent Amy home with a one-week course of antibiotics.

Days later her eyes swelled up and Amy was taken to her GP, who said she was suffering an allergic reaction and gave her antihistamines. Over the next few nights the teenager, who has a sister, Sam, 17, and brother, Ben, 24, was unable to keep any food down and developed thrush on her tongue, which was caused by the antibiotics.

She went back to her GP who said she had a bacterial infection at the back of her throat and she was transferred to the hospital on December 19, where tests revealed she had glandular fever. Glandular fever is a type of viral infection that can cause fever, swollen glands, sore throat and fatigue.

Most patients recover without treatment, but in some cases the infection can spread to other parts of the body, causing more serious secondary infections such as pneumonia, meningitis or inflammation of the heart.

The Carters are waiting for the results of tests to discover what happened to their daughter. An inquest has been opened. Her funeral will take place on January 15, with a memorial service on January 24, which would have been her 16th birthday.

A spokesman for Worcestershire Royal Hospital said: 'The case has gone to the coroner so we have no further comment at this time.'

Democratic leaders are girding for a political war over the health care overhaul heading in to this year's midterm elections, preparing strategies and raising funds to fend off attacks by Republicans eager to capitalize on voter discontent.

Analysts from both parties predict the sweeping impact of the proposed health care changes, which will affect every American, to be the overriding issue, with the strongest and most personal impact in 2010.

Democratic leaders acknowledged this week in last-minute party fundraising appeals that they expect Republicans to come out with both guns blazing in pursuit of major gains in the House and Senate.

"They will spend the next 11 months spinning our health care victory into a weapon and hitting us with it. We might have the momentum now, but we must show the GOP and the pundits that we can sustain it until the 2010 elections," said Sen. Robert Menendez of New Jersey, chairman of the Democratic Senatorial Campaign Committee.

"Now that they lost this battle, they will be focusing their fight -- and their millions and millions of dollars -- on defeating us," he said.

National polls show strong opposition to the bills that have passed the House and Senate and now must be reconciled in a conference committee before facing a final vote. Polling data compiled by the Senate Republicans' campaign committee shows that Democrats are trailing their Republican challengers in every battleground state where opposition is strongest.

In the House, between a dozen and two dozen Democrats who voted for the bill are on their party's vulnerable list.

A Rasmussen poll conducted recently shows that Americans were opposed to the Democratic reforms by 55 percent to 40 percent, and think by a 54 percent to 24 percent margin that its enactment would make the quality of medical care worse. "Those figures have remained fairly consistent for months," Rasmussen said this week.

Democratic pollster Mark Mellman, in a strategy memo provided to Democratic senators last week, said the reason for the health care plan's unpopularity resulted from "voters knowing little about the substance of the plan" and the belief that those on the left remain unhappy with the Senate's decision to drop a government-run health insurance option.

Whatever is in the ultimate bill that Congress sends to President Obama next month for his certain signature, voters from all political persuasions will show their dissatisfaction at the ballot box, said health care policy analyst Grace-Marie Turner of the Galen Institute, a free-market think tank opposed to the reform.

About 10 years ago, the government set some lofty health goals for the nation to reach by 2010. So how did we do? By many measures, not so hot. There are more obese Americans than a decade ago, not fewer. We eat more salt and fat, not less. More of us have high blood pressure. More of our children have untreated tooth decay. The nation has made at least some progress on many other goals. Vaccination rates improved. Most workplace injuries are down. And deaths rates from stroke, cancer and heart disease are all dropping.

As we move into a new decade, the government is analyzing how well the nation met the 2010 goals and drawing up a new set of goals for 2020 expected to be more numerous and -- perhaps -- less ambitious. "We need to strike a balance of setting targets that are achievable and also ask the country to reach," said Dr. Howard Koh, the federal health official who oversees the Healthy People project. "That's a balance that's sometimes a challenge to strike."

The Healthy People objectives were first created in the late 1970s to set an agenda for helping Americans to live longer, healthier lives. It was also an attempt to involve the public and emphasize that many health problems are preventable. Every 10 years, the U.S. Department of Health and Human Services reassesses the goals, and reports on progress made in the previous decade.

Many call the effort a success. The report has been imitated by states and other nations. Because of its importance within public health circles, interest groups jockey to add their goals to the document, which is expanding to more than 1,000 targets. And health agency workers have Healthy People goals memorized. "It is something that we think about all the time," said Dr. Lance Rodewald, a vaccination specialist at the U.S. Centers for Disease Control and Prevention.

But after more than 30 years, the goals aren't well-known to the public and only a modest number have been met. About 41 percent of the 1990 measurable goals were achieved. For the 2000 goals, it was just 24 percent. As for the 2010 goals, data is still being collected, and a final report is not due out until 2011. But it looks like the results will be in the neighborhood of 20 percent, according to a preliminary analysis by the CDC's National Center for Health Statistics. The CDC analysis done in the fall found that just 18 percent of those goals have been met so far. Worse, the nation actually retreated from about 23 percent of the goals.

Healthy People 2010 called for the percentage of adults who are obese to drop to 15 percent. That goal was set at a time when nearly a quarter of all adults were obese. Now, about 34 percent of adults are obese. Some other backslides:

• An estimated 28 percent of adults had high blood pressure in 2000. The goal was to reduce that to 16 percent. But the most recent government data say the proportion has risen to 29 percent.

• About 16 percent of young children had untreated tooth decay in 2000. The target was 9 percent. The latest statistic is about 20 percent.

• The proportion of births by Caesarean section increased despite a 2010 goal of lowering them, and the percentage of infants born very small and fragile also increased.

The nation has had better luck raising childhood vaccination rates, lowering cancer death rates, increasing smoking laws and reducing most types of work injuries.

Democrats are starting to mash together the Senate and House health-care bills, all of the negotiations taking place in secret. One reason to keep quiet is so voters don't discover items like the Senate's destructive change in the way retiree health benefits are taxed. This is a revenue grab that will cost many retirees their private drug benefit coverage, with knock-on harm for the federal budget and financial markets.

When the Medicare prescription drug benefit was created in 2003, one concern was that businesses that provided private drug coverage for seniors would dump them into the new taxpayer-funded plan. So Congress created a modest tax subsidy—equal to 28% of the total cost of a drug plan—to encourage employers to maintain coverage for retirees who would otherwise enroll in Medicare. On average, this subsidy will cost the government about $665 per person in 2011, according to the Employee Benefit Research Institute, while the same Medicare coverage would run about $1,209.

Currently, the $665 a business gains by providing benefits—and keeping one senior off Medicare—is not taxed. By instead treating the subsidy as income taxed at the 35% corporate rate, Democrats expect to raise about $5.4 billion for ObamaCare—and while that's a pittance in the scheme of a new multitrillion-dollar price tag, it's also based on a static tax analysis that is surely wrong.

The cost of offering drug benefits will rise by about $233 per retiree, making Medicare a far more attractive option for businesses. Private drug coverage is already on the decline, but Verizon, Xerox, Boeing, Metlife, Caterpillar and other companies are already warning that they may be forced to cut benefits. (Consider this another reward for the Business Roundtable's decision to promote ObamaCare.)

As more employers drop drug coverage, Congress won't be dispensing as many subsidies with the one hand that it can tax with the other, so revenue will fall. The retirees who lose private benefits will simply move onto Medicare, so public drug spending will also rise. The American Benefits Council, which represents the largest employers, estimates the tax will be a net loser for the government if just one out of four retirees is crowded out of private coverage.

That $233 may not sound like a lot, but under an accounting rule established in 1990, companies are required to report and expense their long-term retiree health liabilities on their financial statements, including actual paid claims and certain future payments. The deferred losses from the tax change thus must be immediately reflected on their balance sheets, which would take a huge bite out of reported earnings in 2010. Given the shaky economy, not to mention the political uncertainty that Washington continues to generate, is this really the best idea?

This is merely one example of how careless Democrats have been about the details as they dash to pass ObamaCare, even as they behave as if the results of their major changes to the health market will match perfectly with their perfectly unrealistic rhetoric.

"One of the things I've learned is that the Econ 101 approach to life where all that matters is the direct financial incentives or penalties is just wrong," Obama budget director Peter Orszag said in December. "Not to say that it doesn't matter, but exclusive focus on rational, perfectly optimizing behavior is just not, not where it's at."

When even the budget scorekeeper spurns economic incentives, you know pure politics is in charge. We suspect the White House will discover soon enough that everyone is a lot more rational, and a lot smarter, that it presumes.

There was a lot of cheering and back slapping last week when President Obama and the Democratic Party leadership in the Senate pushed through legislation reforming the nation’s health care system. The legislation passed with no support from conservative Republicans who essentially offered no alternative but instead simply tried to kill what Obama and the Democrats were pushing.

The reform is not yet law. The Senate version of health care reform must now be reconciled with the version passed earlier by the House of Representatives. Regardless, the fundamental elements of the reform which will most likely emerge in early 2010 are clear. We at Taylor Media Services have reached the following general conclusion: “Obamacare” represents a step in the right direction. It pushes America closer to major European nations and Canada where health care is virtually universal.

Indeed, what Obama has accomplished is a step which America should have taken nearly 40 years ag Virtually all Americans will be covered by some form of health insurance. Among the estimated 47 million people currently without health insurance, only about 17 million will be left uncovered. Perhaps even more importantly Obama forced acceptance of the basic principle that in the richest nation, it was a travesty of justice and fairness that all Americans did not have affordable health care.

Now, for the bad news. In order to get moderate Democrats to support the reforms, Obama and Democratic Party leadership had to compromise to a degree that significantly undermined real reform. Simply put, the reformers compromised far too much with the very major corporations which caused our health care crisis in the first place. The chief wrong is that there in nothing in the legislation which will work to force down health care costs.

This is because the “public option” will be eliminated. The so-called public option was a low-cost government health care insurance program which would have competed with the big insurance companies and would have worked to force down health care costs. But in order to get major private insurers to support the bill, the public option was dropped thus making sure that the major insurance companies will continue to make insane profits.

Indeed, by requiring that roughly 30 million new Americans buy private health insurance, the legislation will actually make the insurance giants richer. Further, in order to get the big pharmaceutical companies on board, an amendment which would have allowed the legal importation of cheaper drugs from Canada was dropped. Thus, the big drug companies will continue to be able to rake in their insane profits.

The bottom line is that there will be an increase in the number of people with health insurance but all provisions which might have worked to hold prices in place or even force them down were stripped from the bill. Thus, as a nation we will end up slightly healthier but poorer as the already rich soak more money from our pockets.

Finally, there is nothing in the legislation which will work to close the various health gaps between whites and minorities, especially poor minorities. Thus, from diabetes to cancer to heart disease, Blacks will continue to die at faster rates than whites.

All in all, Obamacare moves America in the right direction by taking an important step to putting all Americans under the health care insurance blanket. But it was just a wobbly baby step not a giant leap. Doing too much to satisfy the wants of the giant insurance, pharmaceutical and medical care companies undermined the bill and if history is a guide, it may take years, if not decades, to correct the bill’s wrongs.

The Mayo Clinic has dropped Medicare patients at its Glendale, Arizona clinic -- which means that if those on Medicare want to continue seeing their doctors, they will have to pay out of pocket (so much for the promises about being able to keep your doctor, at least if you're on Medicare!).

This is a warning to all those anticipating the brave new world of ObamaCare. Given all the cuts coming to Medicare to balance the bills costs, many phusicians simply won't be able to afford to see Medicare patients -- the government will be paying them too little to do so.

Contrary to what Democrats want you to believe, the government cannot simply mandate the payments that doctors will receive, without regard to market forces. If they continue to try to do so -- and drive private insurers out of business -- the results will be: Rationing. That's because doctors who can't make a decent living will quit, medical care will be scarcer, and it will be allocated on whatever basis government bureaucrats decide to use.

That may be fine for the government insiders, but it's going to be terrible for ordinary Americans. Let's hope this isn't the shape of things to come -- but it's a lot more likely if ObamaCare becomes law.

1 comment:

Allegations of price-fixing, bid-rigging, exclusive sales contracts, local price cutting to freeze out competitors, and the dividing up of markets need to be fully explored through subpoenas and depositions (a law suit by all 50 States and joined by the Feds) so we can get rid of our dysfunctional corporate health care system that's choking the economy to death.

Federal workers and retirees can select plans at a cost range from $100 dollars a month for the cheapest individual coverage to $500 dollars for the most expensive family plan.

I’m voting “MY” pocket book - I want lower premiums and less money taken out of my paycheck - if they want to help spur on the economy they will make sure this happens for all - not just a select group.

90% of the wealth concentrated in 1% of the population is no way to run a country but a heck of a way to establish a royalty ruling class. Yacht sales can not sustain 350 million people. I'm for the public option, competition and a level playing field or break up the big insurers like we did AT&T.

A slavish focus on profit margin might be good for the individual or a business, but it is one helluva lousy way to "govern" a Country. The GOP being a wholly owned subsidiary of Corporate America has a hard time with that concept.

Background

Postings from Brisbane, Australia by John Ray (M.A.; Ph.D.) -- former member of the Australia-Soviet Friendship Society, former anarcho-capitalist and former member of the British Conservative party.

This blog gives a lot of attention to events in Australia and Britain -- places where there already exist systems similar to the one most likely to befall the USA if the Democrats get their way -- "Free" medical care supposedly available to all through government hospitals but with a competing private sector as well. The Canadian system is considered too Soviet to provide a likely model for the USA

TERMINOLOGY: Many of my posts concern the very instructive state of socialized medicine in Australia. Like the USA, Germany and India, Australia has a system of State governments which have substantial independence from the central (Federal) government and it is they who are mainly responsible for "free" health services. It may therefore be useful to some for me to note the standard abbreviations for the States concerned: QLD (Queensland), NSW (New South Wales), WA (Western Australia), VIC (Victoria), TAS (Tasmania), SA (South Australia).

For greatest efficiency, lowest cost and maximum choice, ALL hospitals and health insurance schemes should be privately owned and run -- with government-paid vouchers for the very poor and minimal regulation. Both Australia and Sweden have large private sector health systems with government reimbursement for privately-provided services so can a purely private system with some level of government reimbursement or insurance for the poor be so hard to do?

Conservatives do NOT object to helping the poor. Government welfare legislation in aid of the poor was in fact first introduced by conservatives -- Bismarck and Disraeli in the 19th century. What conservatives want is for the help to be delivered in a sane manner. And anyone who thinks that government bureaucracies can run hospitals well is completely out of touch with reality.

One of the oldest "free" public hospital systems in the world is that in the Australian State where I live: Queensland. It dates from 1944 (Britain's NHS began in 1948). So its advanced state of decay reveals well where the slow cancer of bureaucracy ends up. It now has three "administrative" employees for every medical employee. All those clerks are really good at curing people, I guess! Frequent bulletins on the flailing but ineffectual attempts to "fix" the system will appear here -- as well as bulletins on the dreadful things it does to patients and the long waits they endure.

On all my blogs, I express my view of what is important primarily by the readings that I select for posting. I do however on occasions add personal comments in italicized form at the beginning of an article.

I am rather pleased to report that I am a lifelong conservative. Out of intellectual curiosity, I did in my youth join organizations from right across the political spectrum so I am certainly not closed-minded and am very familiar with the full spectrum of political thinking. Nonetheless, I did not have to undergo the lurch from Left to Right that so many people undergo. At age 13 I used my pocket-money to subscribe to the "Reader's Digest" -- the main conservative organ available in small town Australia of the 1950s. I have learnt much since but am pleased and amused to note that history has since confirmed most of what I thought at that early age.

I imagine that the the RD is still sending mailouts to my 1950s address!

NOTE: The archives provided by blogspot below are rather inconvenient. They break each month up into small bits. If you want to scan whole months at a time, the backup archives will suit better. See here or here